Safe zone for the acetabular component in the concept of spinopelvic relationships

Objective. To analyze the correlation of the acetabular component (AC) position criteria with the sagittal balance criteria in pelvic translation associated with body posture change from a standing to a sitting position and vice versa.

Material and Methods. A prospective study of 20 patients who underwent hip arthroplasty for unilateral coxarthrosis, in the absence of signs of arthrosis and dysfunction of the contralateral joint was conducted. A the 20th week after surgery, an X-ray examination of the spine and hip joints was performed with an analysis of anteversion, inclination, AC anteversion, PT, SS, PTsit. A search for correlations between the indicators was carried out using the Spearman correlation method. Numerical associations were identified by calculating the Pearson correlation coefficients. Statistical hypotheses were tested at a critical significance level of 0.05, i.e. the difference was considered statistically significant when the level of p <0.05 was achieved.

Results. A direct correlation was found between the changes in the sagittal balance parameters (SS, PT) and the AC position. Comparison of the mean values and medians of the studied parameters measured in the standing and sitting positions showed the high correlation between them. The same dynamics of changes in the values between the AC anteversion and pelvic PT parameters was noted. A high direct correlation of the difference (Δ) in the AC anteversion values with PT in standing position, and a strong correlation of Δ in the AC anteversion values with PT in sitting position indicates an indirect relationship between the sagittal balance parameters and the AC position parameters through the AC anteversion parameter. This is confirmed by the strong direct correlation of Δ (sitting/standing) PT with Δ (sitting/standing) AC inclination (0.67) and Δ (sitting/standing) AC anteversion (0.82), and by an inverse correlation of Δ (sitting/standing) SS with Δ (sitting/standing) AC inclination and Δ (sitting/standing) AC anteversion (–0.7).

Conclusion. Comparison of sagittal balance parameters (SS, PT) measured in standing and sitting positions with the position of the AC showed their direct high correlation with each other.  Acetabular anteversion serves as a connecting criterion between sagittal balance parameters and the spatial position of the acetabular cup.

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